As we prepare for a second wave Ottawa needs to act quickly

"The feds should aim to lead. They can establish the Canada Testing and Contact Tracing Service, training thousands of unemployed workers, university graduates and retirees in the critical work of calling cases and tracking down their contacts."

As spring arrives and COVID-19 case numbers drop, provinces have started to ease their lockdowns. The impulse to lift these measures is understandable from a human and political perspective, but it would be a mistake to think that as we reopen the economy, most of the hard work has been accomplished.

In fact, our biggest challenge lies ahead. The problem is that as of now, Canada isn’t ready to take it on.

Lockdowns and stay-at-home orders were necessary to flatten the curve and prevent a surge of deaths while keeping hospitals from being overwhelmed. The achievement of that goal varies widely — from very convincing in B.C. to highly dubious in Quebec — but it’s clear that lockdown is not the outcome any society should aspire to.

Lockdown measures —crude, burdensome and economically harmful as they are — do not rid us of coronavirus, or fully control it. They simply help get us over the first hump. Their purpose is to buy time — time to plan, organize, and formulate a more sustainable response to contain or eradicate the virus.

Strange as it may sound, lockdowns are the easy part. They’re clear, unambiguous and straightforward to communicate. The next steps — mass testing, contact tracing, and isolation — are more subtle and complex. If lockdowns are a field amputation — urgent and crude — the next phase is microsurgery, painstaking and precise.

Countless articles and op-eds have summarized the elements of a successful response to coronavirus after lockdown. It boils down to this. You need to test widely, frequently and randomly to discover new outbreaks and find asymptomatic carriers. You need to trace cases and their contacts quickly, preferably within 24 hours, and you need to isolate positive or high-risk cases at home or elsewhere, to prevent spread. The goal is to bring the average number of people each positive individual infects, the so-called Ro (“R-naught”), to less than one.

Measures like universal masking and deciding which businesses can open are important to managing the post-lockdown response. But the countries with standout pandemic management, like Taiwan, South Korea and New Zealand, all perform well on testing, contact tracing and isolation. We should aspire to join their ranks.

Yet Canada continues to lag on testing, as evidenced by one key measure: the test positivity rate, or the share of overall tests that are positive. This indicator tells us whether testing is adequately capturing the extent of the epidemic. If you’re getting too many positives, it means you’re testing too few people, or that your outbreak is out of control. A reasonable target is 2 to 3 per cent positivity. Canada is at 5.8 per cent over the duration of the pandemic, although the trend has been improving. Still, that means we need to be testing more.

Unfortunately, the two provinces at the centre of the pandemic have only paid lip service to a massive scale-up in testing, contact tracing and isolation. A testing laggard from the start, Ontario’s test-positivity rate was finally improving this month, but it’s jumped back up above 5 per cent over the past week. Ontario plans to increase testing while reopening, making it difficult to tell whether an uptick in cases would be caused by increased testing or by the restart. It would have been wiser to ramp up testing first.

Quebec, whose outbreak is far worse than Ontario’s, has hung its reopening plans on a recent run of lower daily death tolls, which still fluctuate between 50 and 100 while hundreds of new cases are recorded daily. Quebec’s test positivity rate is around 13 per cent overall, though it has improved recently. Although Quebec prides itself on high testing per capita, it’s had a slow and uneven upward trend in testing in May, despite promises of a rapid scale-up. Meanwhile, Quebec’s contact tracing infrastructure runs on fax machines.

Where is the federal government in all of this? Generally keeping to itself, unwilling to dive into management of the health crisis, worried as usual of being accused of big-footing into provincial jurisdiction. But recent comments by the PM seem to indicate greater openness towards leading a national effort on testing and contact tracing.

The limits of federal action are clear. The challenge is even greater when it comes to Quebec, especially when the Premier is a seasoned nationalist. But the stakes now are higher than at any time since World War II. This is a national crisis that may easily get worse, especially if we are hit by a second wave without the infrastructure to cope with it.

So here’s a proposal. The feds should aim to lead. They can establish the Canada Testing and Contact Tracing Service, training thousands of unemployed workers, university graduates and retirees in the critical work of calling cases and tracking down their contacts.

The organization’s services could be offered to the provinces free of charge and Ottawa could farm out day-to-operation to an organization like the Red Cross to minimize allegations of a federal power grab. Put the burden on the provinces to refuse a critical service and explain the decision to its citizens.

The feds should also leverage their role where their jurisdiction is clear. They need to develop clear border reopening policies, and plans for quarantining and isolating incoming travellers. Air travel in the post-coronavirus era will need new processes and rules to restart safely, including revamped security screening, temperature scanning, and airport retrofits. That’s just a start. In a pandemic that has affected every aspect of daily life, there is no shortage of work to be done.

The novel coronavirus represents a massive collective challenge, one in which government action is indispensable. Ottawa has recognized this with its rapid and generous financial support for workers and businesses. But it needn’t act only as an ATM.

The federal government has the leadership and technocratic expertise to help us proactively manage this crisis. We can’t leave our national fate in the hands of disparate local and provincial public health authorities, well-meaning as they may be. With a second wave upon us, and an effective vaccine at least 18 months away, we can’t just shelter in place, or rely on the same old ways of doing things. We need bold action and big ideas. It’s time to get out there and do what Canadians do best: stick together, and get to work.

The views, opinions and positions expressed by all iPolitics columnists and contributors are the author’s alone. They do not inherently or expressly reflect the views, opinions and/or positions of iPolitics.

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Samuel Freeman is a pediatrician and writer in Montreal. Alan Freeman is an iPolitics columnist and Honorary Senior Fellow at the University of Ottawa’s Graduate School of International and Public Affairs.